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Comparing the Efficacy of Paracetamol, Diclofenac, and Ketorolac on Post-Appendectomy Outcomes in Children and Adolescents
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Abstract

urgent surgical intervention and appendectomy until now represent standard treatment for uncomplicated cases of appendicitis. Nausea, vomiting and pain after surgery are the most frequent issues facing patients and affecting patient quality of life and responsible for many cases of readmission after surgery. Ketorolac and diclofenac represent the most commonly prescribed non-steroidal anti-inflammatory used in postoperative setting and they cause many side effects as gastrointestinal, kidney and cardiac adverse effect in addition to increased risk of bleeding. Paracetamol is currently among the most frequently prescribed medication worldwide and it can be used safely for all age groups. This study aimed to compare the analgesic efficacy and safety of paracetamol, diclofenac, and ketorolac when used after appendectomy and to assess their efficacy regarding nausea and vomiting in children and adolescents. A randomized, single-blinded, comparative, observational prospective clinical study was carried out on patients diagnosed with acute appendicitis and assigned for emergent appendectomy between October 2018 to May 2019 in Al- Zahraa Teaching Hospital in Al-Najaf province, Iraq.120 patients were randomly distributed into three groups who received diclofenac sodium suppositories (2mg/kg), IV Paracetamol )15mg/ kg every 6 hr.(, and IV  Ketorolac )0.5mg/ kg( immediately after surgery. All patients were observed for pain, nausea and vomiting and bleeding. Patients received ketorolac had a high percentage of the decrease in pain score between 30 and 60 min. after surgery, while paracetamol was the next and diclofenac sodium was the last. Regarding nausea and vomiting after surgery, ketorolac had higher percentage of the decrease in nausea, vomiting score during first day after surgery followed by diclofenac and paracetamol respectively. The present study also showed that there is no significant difference between groups regarding bleeding after surgery. It is concluded that ketorolac has higher analgesic efficacy compared with paracetamol and diclofenac with no risk of nausea and vomiting and bleeding when used after appendectomy.

Keywords: Postoperative pain, Ketorolac, Diclofenac, Paracetamol, Appendectomy.

 

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Publication Date
Tue Feb 08 2022
Journal Name
South Asian Journal Of Social Sciences And Humanities
The Impact of University Leadership and the University Organizational Environment on the Performance of staff: A Case Study at Al Maaqal University (Private Sector)
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This study aims to explore the impact of the interaction of the university leadership and the university organizational environment on the performance level of the staff at Al-Maaqal university. This university was chosen as a field of study because it is a new university and needs studies that develops and contributes to improve its overall performance. The problem defined by the following question: to what extent does the interaction of the university leadership and the university organizational environment affect the performance level of the teaching staff at AlMaaqal University?). The method of this study adopted a major hypothesis in which there is a statistically significant effect of university leadership and university environment o

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The added value of internal audit and its role in achieving independence and responsibility: applied research in the Rafidain State Company for Dams implementation
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The added value of internal audit greatly contributes to adding value to the institution, but most departments of economic units in Iraq neglected the role of internal audit and the added value that can be achieved by those institutions, since the term added value of internal audit is a relatively vague term from the premise that what cannot be measured is difficult Determine it, and perhaps descriptive standards for it is the extent of compliance with international auditing standards (IIA).

The research aims to study the procedures and results of auditing to verify that they have given an added value to the audit with a positive impact, develop its aspects and research, identify deficiencies for the audi

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
Ministry of Hamdy Al-Bachachy (the first) 3rd of Jun – 28 Aug. 1944 in Iraq The Ministry forum and the political and economical issues
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This study Studied Ministry of Hamdy Al-Buchachy(the first)and explain the features of
this Ministry in a critical time in the history of Iraq. The second world war had began and its
end had reached .The political situation in Iraq is so complicated. The Ministry had made
many things. The Ministry had situated in internal and external complicated time. The
situation in Iraq was so difficult, therefore the recommendor (Abdul-Ilah)asked Hamdy Al-
Bachachy to make be the head of the new governments Al-Bachachy had made irrelevant
government, thus it didn’t last more than three months and the British governorate and of
direct in terference in Iraq who worked to reduce the Iraqi army and the Minister of Defence
refus

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Publication Date
Wed Jul 24 2024
Journal Name
مداد الآداب
Navigating the Evolving Tourism Landscape: Examining the Challenges and Opportunities for TripAdvisor and Travelocity in the Era of AI:A Comparative Analysis of Innovation Strategies
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The tourism industry has undergone exponential transformation, reshaped by online travel agencies (OTAs), shifting consumer preferences, and technological advancements. Established OTAs like TripAdvisor and Travelocity face pressures to adapt their strategies to capitalize on these disruptive landscape changes. This research involves a comparative analysis examining the key challenges confronting TripAdvisor and Travelocity, with a focus on opportunities to leverage artificial intelligence (AI) in enhancing personalization and the traveler experience. The study utilizes publicly available data on the companies and academic literature on AI innovation diffusion. Findings reveal that while TripAdvisor has actively developed AI-based trip plan

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Publication Date
Tue Dec 16 2008
Journal Name
Journal Of Planner And Development
City of Baghdad Analysis of the mechanisms of economic action in the development and development
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The economy of a city has an important role not only in its establishment but also in its development. This is quite clear in the city of Baghdad throughout its history since its building in 762 A.D. In addition, most of its problems that the city is suffering from are basically related to not giving enough importance to the economic factors in the master planning of Baghdad since 1950’s. This may explain the failiars of master plans in dealing with the actual population growth and the city's inability to absorb such increases and interrelated and diverse activities which are negatively reflected on the economic variables particularly the effect on the land values, and the strong competitions amongst the land uses without previ

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Publication Date
Thu Apr 01 2021
Journal Name
Biochem. Cell. Arch
STUDY ON THE MUTATION OF ASXL1 IN ACUTE MYELOID LEUKEMIA IN IRAQI PATIENTS
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The present study was designed to shed light on the molecular effects caused by acute myeloid leukemia (AML). It was also aimed to investigate ASXL1 point mutations in newly AML patients as compared to healthy control. The study comprised of 43 AML Iraqi patients and their ages ranged between 16-75 years. It included 23 females and 20 males compared with 20 healthy controls. Results revealed that the extracted DNA from 30 AML patients and amplified by PCR to obtain ASXL1 gene from exon 12 showed larger bands (479). Among forty three patients, two of them displayed point mutations of deletion and substitution, while the others were normal since no mutations were detected. The total of mutations in two mutated patients was 27 mutations, the m

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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Murabaha for real estate and its reflection on the profitability of Al-Nahrain Islamic Bank: applied research
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The Islamic Bank of Al-Nahrain offers a formula for financing the purchase of real estate through a deferred sale contract, through Murabaha to the order to buy, and the payment of the price is in the form of instalments that include (the purchase price of the profit and the mutual agreement on the real estate). This research aims to show the reflection of real estate murabaha on the bank's investments, by measuring the effect of real estate murabaha on the profits achieved by the Islamic Bank of Al-Nahrain Bank. The growth of 'real estate murabaha' realized from the 'amounts granted by Bank X, in addition to analyzing the financial ratios of profitability indicators, including (return on deposits Y2) and for the years (2016 - 20

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Publication Date
Sat Feb 14 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of the examination stress on periodontal health status and salivary IL-1? among Iraqi dental students
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Background: Periodontal diseases (PD) are common chronic inflammatory diseases caused by pathogenic microorganisms colonizing the gingival area and inducing local and systemic elevations of pro-inflammatory cytokines resulting in tissue destruction by a destructive inflammatory process. Stress was considered as one of the important risk factors that cause many inflammatory diseases including PD. The purpose of this study wasto determines and compares clinical periodontal parameters (PLI, GI and BOP), stress level and salivary IL-1? level among dental students before, during and after mid-year exam, also to find the correlation among stress, IL-1? and clinical periodontal parameters. Materials and methods: The sample was consisted of 24 dent

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Publication Date
Tue Sep 04 2018
Journal Name
Al-khwarizmi Engineering Journal
Study the Effect of Cutting Parameters on Temperature Distribution and Tool Life During Turning Stainless Steel 316L
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This paper is focused on studying the effect of cutting parameters (spindle speed, feed and depth of cut) on the response (temperature and tool life) during turning process. The inserts used in this study are carbide inserts coated with TiAlN (Titanum, Aluminium and Nitride) for machining a shaft of stainless steel 316L. Finite difference method was used to find the temperature distribution. The experimental results were done using infrared camera while the simulation process was performed using Matlab software package. The results showed that the  maximum difference between the experimental and simulation results was equal to 19.3 , so, a good agreement between the experimental and simulation results  was achieved. Tool life w

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Publication Date
Tue Sep 01 2020
Journal Name
Baghdad Science Journal
A Comparative Study on the Active Constituents, Antioxidant Capacity and Anti-Cancer Activity of Cruciferous Vegetable Residues
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This study is pointed out to estimate the effectiveness of two solvents in the extraction and evaluating the active ingredients and their antioxidant activity as well as anti-cancer efficiency. Therefore, residues from four different Brassica vegetables viz. broccoli, Brussels sprout, cauliflower, and red cherry radish were extracted using two procedures methods: methanolic and water crude extracts. Methanol extracts showed the highest content of total phenolic (TP), total flavonoids (TF), and total tannins (TT) for broccoli and Brussels sprouts residues. Methanolic extract of broccoli and Brussels sprouts residues showed the highest DPPH· scavenging activity (IC50 = 15.39 and 18.64 µg/ml). The methanol and water ex

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